The Herts and Minds study: feasibility of a randomised controlled trial of Mentalizationbased Treatment versus usual care to support the wellbeing of children in foster care

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Background: There is a lack of well-designed randomized controlled trials (RCTs) to investigate the efficacy of psychological therapies for children in foster care with emotional and behavioural difficulties. Mentalization-based therapy (MBT) focuses on supporting the carer-child relationship by promoting reflective capacity. This study examined the feasibility and acceptability of an RCT of MBT, delivered in a family-format, for children who are in foster care in the UK. Method: Herts and Minds was a phase II, blinded feasibility RCT with follow-up of at 12 and 24 weeks post-randomisation. Participants were children (age 5-16) in foster care referred to a targeted mental health service, who had some level of difficulty as identified by the Strengths and Difficulties Questionnaire (SDQ). Aims were to assess: the feasibility of recruitment processes and study uptake; capacity to train mental health practitioners to deliver MBT to an acceptable level of treatment integrity; establish acceptability and credibility of MBT as an intervention for children in foster care; establish feasibility and acceptability to participants of conducting an RCT; and estimate the likely treatment efficacy effect size. Participants were randomly allocated to either MBT (n = 15) or Usual Clinical Care (UCC) (n = 21) individually or in sibling groups. A range of qualitative and quantitative data was gathered to assess feasibility. Results: Feasibility was established with regard to: capacity to recruit participants to a study; capacity to train mental health practitioners to deliver MBT to an acceptable level of treatment integrity; acceptability and credibility of MBT; and feasibility and acceptability to participants of conducting an RCT. A number of issues made it difficult to estimate a likely treatment efficacy effect size. Conclusion: With modifications, it is feasible to run an RCT of MBT for children in foster care. Both the therapy and research design were acceptable to participants, but modifications may be needed regarding both the timing of assessments and the identification of appropriate primary outcome measures. Given the lack of evidenced based therapies for this population, such a trial would be a significant contribution to the field. Findings may be useful for other groups planning clinical trials of psychological therapies for children in foster care. Trial registration: ISRCTN 90349442. The trial was retrospectively registered on 6 May 2016.Peer reviewedFinal Published versio

A qualitative analysis of goals set by foster carers seeking support for their child’s emotional well-being

The needs of foster carers are complex as children in their care often present with complex emotional and behavioural difficulties. Previous studies have examined foster carers’ perceptions of the unmet needs of the children in their care but there is a lack of knowledge regarding carers’ own goals when seeking professional help. The present study seeks to fill this gap by examining the goals that carers who are looking after children with emotional and/or behavioural difficulties set at the start of an intervention, the Reflective Fostering Programme, designed to support them. Twenty-six foster carers were asked to complete a Goal-Based Outcome Measure (GBOM) before starting the programme. Qualitative content analysis revealed five main categories of goals. Three were child focused (child’s relationships, challenging behaviours and emotions) and two were foster carer focused (personal goals and goals related to participating in the programme). By understanding the types of goals meaningful to foster carers, interventions can be developed to better target their specific needs and allow outcome measures to be more closely aligned to their goals. Results are discussed in terms of implications for the development and evaluation of interventions to support foster carers and the children they look after

Circulating C-peptide levels in living children and young people and pancreatic beta cell loss in pancreas donors across type 1 diabetes disease duration.

This is the author accepted manuscript. The final version is available from the American Diabetes Association via the DOI in this record Data Availability: Further information about the data is available from the corresponding author upon request.C-peptide declines in type 1 diabetes although many long-duration patients retain low, but detectable levels. Histological analyses confirm that beta cells can remain following type 1 diabetes onset. We explored the trends observed in C-peptide decline in UK Genetic Resource Investigating Diabetes (UK GRID) cohort (N=4,079), with beta cell loss in pancreas donors from the network for Pancreatic Organ donors with Diabetes (nPOD) biobank and the Exeter Archival Diabetes Biobank (EADB) (combined N=235), stratified by recently reported age at diagnosis endotypes (< 7, 7-12, ≥ 13 years) across increasing diabetes durations. The proportion of individuals with detectable C-peptide declined beyond the first year after diagnosis, but this was most marked in the youngest age group (< 1 year duration: age < 7 years: 18/20 (90%), 7-12 years: 107/110 (97%), ≥ 13 years: 58/61 (95%) versus. 1-5 years post diagnosis: < 7 years: 172/522 (33%), 7-12 years: 604/995 (61%), ≥ 13 years: 225/289 (78%)). A similar profile was observed in beta cell loss, with those diagnosed at younger ages experiencing more rapid loss of islets containing insulin-positive (insulin+) beta cells < 1 year post diagnosis: age < 7 years: 23/26 (88%), 7-12 years: 32/33 (97%), ≥ 13 years: 22/25 (88%) versus. 1-5 years post diagnosis: < 7 years: 1/12 (8.3%) ,7-12 years: 7/13 (54%), ≥ 13 years: 7/8 (88%)). These data should be considered in the planning and interpretation of intervention trials designed to promote beta cell retention and function.Diabetes UKDiabetes UKDiabetes UKThe Leona M. & Harry B. Helmsley Charitable TrustJuvenile Diabetes Research FoundationWellcome Trus

HAP2(GCS1)-Dependent Gamete Fusion Requires a Positively Charged Carboxy-Terminal Domain

HAP2(GCS1) is a deeply conserved sperm protein that is essential for gamete fusion. Here we use complementation assays to define major functional regions of the Arabidopsis thaliana ortholog using HAP2(GCS1) variants with modifications to regions amino(N) and carboxy(C) to its single transmembrane domain. These quantitative in vivo complementation studies show that the N-terminal region tolerates exchange with a closely related sequence, but not with a more distantly related plant sequence. In contrast, a distantly related C-terminus is functional in Arabidopsis, indicating that the primary sequence of the C-terminus is not critical. However, mutations that neutralized the charge of the C-terminus impair HAP2(GCS1)-dependent gamete fusion. Our results provide data identifying the essential functional features of this highly conserved sperm fusion protein. They suggest that the N-terminus functions by interacting with female gamete-expressed proteins and that the positively charged C-terminus may function through electrostatic interactions with the sperm plasma membrane

Analysis of parcel-based image classification methods for monitoring the activities of the Land Bank of Galicia (Spain)

[EN] The abandonment of agricultural plots entails a low economic productivity of the land and a higher vulnerability to wildfires and degradation of affected areas. In this sense, the local government of Galicia is promoting new methodologies based on high-resolution images in order to classify the territory in basic and generic land uses. This procedure will be used to control the sustainable management of plots belonging to the Land Bank. This paper presents an application study for maintaining and updating land use/land cover geospatial databases using parcel-oriented classification. The test is performed over two geographic areas of Galicia, in the northwest of Spain. In this region, forest and shrublands in mountain environments are very heterogeneous with many private unproductive plots, some of which are in a high state of abandonment. The dataset is made of high spatial resolution multispectral imagery, cadastral cartography employed to define the image objects (plots), and field samples used to define evaluation and training samples. A set of descriptive features is computed quantifying different properties of the objects, i.e. spectral, texture, structural, and geometrical. Additionally, the effect on the classification and updating processes of the historical land use as a descriptive feature is tested. Three different classification methodologies are analyzed: linear discriminant analysis, decision trees, and support vector machine. The overall accuracies of the classifications obtained are always above 90 % and support vector machine method is proved to provide the best performance. Forest and shrublands areas are especially undefined, so the discrimination between these two classes is low. The results enable to conclude that the use of automatic parcel-oriented classification techniques for updating tasks of land use/land cover geospatial databases, is effective in the areas tested, particularly when broad and well defined classes are required.The authors appreciate the collaboration and support provided by Xunta de Galicia, Sociedade para o Desenvolvemento Comarcal de Galícia, and Banco de Terras de Galicia. The financial support provided by the Spanish Ministerio de Ciencia e Innovación in the framework of the projects CGL2010-19591/BTE and CGL2009-14220 is also acknowledged.Hermosilla, T.; Díaz Manso, J.; Ruiz Fernández, LÁ.; Recio Recio, JA.; Fernández-Sarría, A.; Ferradáns Nogueira, P. (2012). Analysis of parcel-based image classification methods for monitoring the activities of the Land Bank of Galicia (Spain). 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Int Arch Photogramm Remote Sens Spat Inf Sci 38:217–222Perveen F, Nagasawa R, Ali S, Husnain (2008) Evaluation of ASTER spectral bands for agricultural land cover mapping using pixel-based and object-based classification approaches. Int Arch Photogramm Remote Sens Spat Inf Sci 37(4-C1)Petit CC, Lambin EF (2002) Impact of data integration technique on historical land-use/land-cover change: comparing historical maps with remote sensing data in the Belgian Ardennes. Landsc Ecol 17:117–132Quinlan JR (1993) C4.5: Programs for machine learning. Kaufmann, San FranciscoRabe A, van der Linden S, Hostert P (2010) imageSVM, Version 2.1. www.hu-geomatics.deRecio JA, Hermosilla T, Ruiz LA, Fernández-Sarría A (2011) Historical land use as a feature for image classification. Photogramm Eng Remote Sens 77(4):377–387Ruiz LA, Fernández-Sarría A, Recio JA (2004) Texture feature extraction for classification of remote sensing data using wavelet decomposition: a comparative study. 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Calf health from birth to weaning. I. General aspects of disease prevention

Calfhood diseases have a major impact on the economic viability of cattle operations. This is the first in a three part review series on calf health from birth to weaning, focusing on preventive measures. The review considers both pre- and periparturient management factors influencing calf health, colostrum management in beef and dairy calves and further nutrition and weaning in dairy calves

Computational analysis of expression of human embryonic stem cell-associated signatures in tumors

<p>Abstract</p> <p>Background</p> <p>The cancer stem cell model has been proposed based on the linkage between human embryonic stem cells and human cancer cells. However, the evidences supporting the cancer stem cell model remain to be collected. In this study, we extensively examined the expression of human embryonic stem cell-associated signatures including core genes, transcription factors, pathways and microRNAs in various cancers using the computational biology approach.</p> <p>Results</p> <p>We used the class comparison analysis and survival analysis algorithms to identify differentially expressed genes and their associated transcription factors, pathways and microRNAs among normal vs. tumor or good prognosis vs. poor prognosis phenotypes classes based on numerous human cancer gene expression data. We found that most of the human embryonic stem cell- associated signatures were frequently identified in the analysis, suggesting a strong linkage between human embryonic stem cells and cancer cells.</p> <p>Conclusions</p> <p>The present study revealed the close linkage between the human embryonic stem cell associated gene expression profiles and cancer-associated gene expression profiles, and therefore offered an indirect support for the cancer stem cell theory. However, many interest issues remain to be addressed further.</p

Systematic evaluation of immune regulation and modulation

Cancer immunotherapies are showing promising clinical results in a variety of malignancies. Monitoring the immune as well as the tumor response following these therapies has led to significant advancements in the field. Moreover, the identification and assessment of both predictive and prognostic biomarkers has become a key component to advancing these therapies. Thus, it is critical to develop systematic approaches to monitor the immune response and to interpret the data obtained from these assays. In order to address these issues and make recommendations to the field, the Society for Immunotherapy of Cancer reconvened the Immune Biomarkers Task Force. As a part of this Task Force, Working Group 3 (WG3) consisting of multidisciplinary experts from industry, academia, and government focused on the systematic assessment of immune regulation and modulation. In this review, the tumor microenvironment, microbiome, bone marrow, and adoptively transferred T cells will be used as examples to discuss the type and timing of sample collection. In addition, potential types of measurements, assays, and analyses will be discussed for each sample. Specifically, these recommendations will focus on the unique collection and assay requirements for the analysis of various samples as well as the high-throughput assays to evaluate potential biomarkers

Herpes simplex virus encephalitis in pregnancy - a case report and review of reported patients in the literature

BACKGROUND: Herpes simplex virus (HSV) encephalitis is the most common sporadic cause of encephalitis with significant morbidity and mortality that is drastically reduced by early antiviral treatment. CASE PRESENTATION: We report a 37 year old woman, 33 weeks pregnant, who presented with seizures due to proven HSV-1 encephalitis, and who had had a previous episode of probable viral encephalitis aged 14 years. She was successfully treated with aciclovir on both occasions and, in the latter, went on to deliver a healthy infant. This case is compared with 17 cases of HSV encephalitis in pregnancy in the literature identifying a predominance in the late 2nd and 3rd trimesters, perhaps in part due to immunological changes in pregnancy. The clinical presentation is also compared with non-pregnant patients with HSV encephalitis in the largest prospective UK and European studies. We also present practical advice on management from recent national guidelines. CONCLUSION: When pregnant women present with new seizures, headache, impaired consciousness or altered behaviour urgent investigation is required to identify common diagnoses, such as eclampsia, venous sinus thrombosis and metabolic disturbances. Nevertheless, viral encephalitis is a very treatable cause of this presentation with potentially serious complications if missed, and may be more common in latter stages of pregnancy. Encephalitis should not be discounted if the patient is afebrile, has a normal Glasgow coma score, or the cerebrospinal fluid white cell count is only slightly elevated, as these features are well recognised in viral encephalitis